title: The diagnosis and surgical treatment of pancreatoblastoma in adults: a case series and review of the literature.
abstract: BACKGROUND
  Pancreatoblastoma is an extremely rare pancreatic neoplasm in adults. The aim of this study is to report our experience with adult pancreatoblastoma as well as review the cases reported in the literature in order to provide guidelines for the management of patients with this rare neoplasm.
  
  
  METHODS
  We have encountered three cases of pancreatoblastoma in adults at our institution in addition to the 30 cases reported to date in literature.
  
  
  RESULTS
  The median age of pancreatoblastoma in adults is 37 years (range, 18-78 years); men and women are similarly affected (male/female = 16/17). The behavior of pancreatoblastoma is clearly that of a malignant neoplasm, with local invasion, recurrence, and metastasis. Among the adult reported cases, at diagnosis or operation, metastasis and/or local invasion was found in 14 of 31 adult patients (46 %) (2 patients had no data) The survival was significantly higher in patients with resected tumor (resection only and resection + adjuvant chemo/radiotherapy) when compared to unresected patients (palliative chemo/radiotherapy and no treatment), (p = 0.008, HR = 0.20).
  
  
  CONCLUSIONS
  When disease is localized, the treatment of choice is a complete surgical resection. The role of adjuvant chemotherapy or radiotherapy is still unclear based on the very small number of patients treated.
authors.affiliation: Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Bulent
authors.initials: B
authors.lastname: Salman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Brat
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: Aatur D
authors.initials: AD
authors.lastname: Singhi
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Herman
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D055815:Young Adult